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Quality Improvement Nurse, RN

4 months ago

Rancho Cucamonga CA United States IEHP Full time

Start your journey towards a thriving future with IEHP and apply TODAY

Pay Range

USD $43.87 - USD $58.13 /Hr.


What you can expect

Under the direction of the Supervisor, Clinical Quality Improvement, the HEDIS Improvement Nurse provides support to the Supervisor, Clinical Quality Improvement and IEHP departments on HEDIS improvement related issues, serving as a resource for internal and external customers. Is able to interpret clinical data for QI-related studies for medical management. This position maintains a working knowledge of the current medical management system (MedHOK), business processes and workflows. Maintains summarized information for Quality Systems related to modified and new regulatory requirements for medical management from DHCS, DMHC and CMS.

Additional Benefits

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

  • Competitive salary.
  • Hybrid schedule.
  • CalPERS retirement.
  • State of the art fitness center on-site.
  • Medical Insurance with Dental and Vision.
  • Life, short-term, and long-term disability options
  • Career advancement opportunities and professional development.
  • Wellness programs that promote a healthy work-life balance.
  • Flexible Spending Account – Health Care/Childcare
  • CalPERS retirement
  • 457(b) option with a contribution match
  • Paid life insurance for employees
  • Pet care insurance

Qualifications

Education & Experience

  • Associates degree required.
  • Three (3) or more years of any individual or combined experience in quality assurance, utilization management, case management, and/or health care informatics is required.
  • Experience preferably in an HMO or managed care setting.

Key Qualifications

  • Working knowledge of NCQA HEDIS technical specifications, medical terminology, and health plan processes preferred.